For many pregnant women, bumping up their flossing routine -- much less scheduling their first dental visit in years -- may fall last on their to-do lists.

But for dentists and doctors, the connections between the oral health of mothers and the health of their babies -- before and after they're born -- are vitally important.
"Prenatal dental care is huge," said Justin Rader, director of the Dirne Dental Clinic in Coeur d'Alene. "It's big for the fetus's health, for the mother's health."
Many women miss out, however. According to a 2010 report released by the Spokane Regional Health District, just 56 percent of women reported they visited the dentist while they were pregnant.
That kind of data isn't available about North Idaho residents, said Linda Harder, a health education specialist at the Panhandle Health District. But, seeing a need, the district provided free fluoride treatments and cleanings to some low-income women.
"With those gals, quite a few of them had not seen a dentist in years, and it was pretty horrendous," Harder said.
That's during a time when women's oral health may be at especially high risk, which research suggests could put their babies' health at risk, too. Here's why pregnancy is hard on mothers' mouths -- and how oral health can affect pregnancy.
Pregnancy changes what you eat -- and what you can't stand.
For many pregnant women, the smell or taste of toothpaste induces nausea, and they brush less thoroughly.
Meanwhile, they indulge pregnancy cravings or eat sugary snacks or sugary drinks to try to combat first-trimester nausea, which also can contribute to decay.
Then there's the vomiting. When women experience morning (or afternoon or evening) sickness, the acid can erode teeth.
After morning sickness, women should rinse their mouths with water and use a fluoride rinse, but hold off brushing for 20 minutes to allow the acid to dissipate, said Melissa Haidu, dental director at CHAS. The acid softens tooth enamel, and brushing them right away just makes it worse.
Pregnancy hormones affect your mouth.
Bleeding gums are common in women who never suffered that problem before pregnancy.
"A lot of my pregnant patients come in and say, 'My gums are just bleeding and bleeding and bleeding, and I don't know what to do,'" Haidu said.
Researchers say high progesterone and estrogen levels are connected to gingivitis.
"For pregnant women, your hormones are out of whack," said Jessica Pearson, dental department supervisor at the Riverstone Family Health Clinic in northeast Spokane.
Swollen, tender gums can lead to serious bacterial infections in your mouth, called periodontitis.
Research suggests bacteria from infections in your mouth can reach developing fetuses.
A cavity in your tooth can affect your whole body, Rader said. When pregnant women allow a cavity to go untreated, "they're affecting not only their health but the fetal development."
When a pregnant woman has a tooth abscess -- a collection of pus, basically, as a result of decay or a broken or chipped tooth -- acid and bad bacteria are injected into her bloodstream when she bites down, Rader said. The bacteria can reach the baby, slowing its development, he said.
The research isn't conclusive, according to the oral-health report by the Spokane Regional Health District.
But early research suggests there's an increased risk for preterm birth or low birth weight among women with dental infections, the report said. As the bacteria enter the bloodstream and then the uterus, they trigger the production of chemicals suspected of inducing preterm labor.
With every sweet kiss comes a dose of bacteria, too.
The relationship between the oral health of mothers and their babies' health continues after the babies are born.
Each person has his or her own oral microflora, which is what dentists call the bacterial environment in your mouth.
Good bacteria help ward off bad ones, creating a "healthy biofilm" around your teeth to protect them, Rader said. Bad bacteria contribute to tooth decay.
When mothers kiss their babies, share food or silverware with them or transfer saliva in any way, they're transferring their bacteria.
Women with healthy mouths will transmit less harmful bacteria to their babies, improving the child's chances of good oral health.
"Babies are born without all the bacteria in the mouth that we have," Haidu said. "They have some, but not the mess we have."
(c)2012 The Spokesman-Review (Spokane, Wash.)
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